Adrenal Lymphangioma Mimicking Renal Cyst: A Case Report and Review of the Literature

Abstract

We present a case of a 44-year-old female who was evaluated for left recurrent flank and abdominal pain. Abdominal ultrasonography demonstrated a large cystic mass on the upper pole of the left kidney. Magnetic resonance imaging showed a large, homogenous cystic mass measuring 8.5 × 9.5 cm with well-defined contours, being hypointense on T1-weighted images and hyperintense on T2-weighted images on the upper pole of the left kidney without a distinct plan between adrenal gland. According to clinical and radiological findings, surgical excision was carried out with a subcostal flank incision. Histologic and immunohistochemical examination demonstrates that the definite diagnosis is cystic lymphangioma of the left adrenal gland. Adrenal lymphangioma is a very rare lesion. This is the unique case of an adrenal lymphangioma considered as a renal cyst because of its radiological appearance.

Cystic lymphangioma of the adrenal gland: report of a case and review of the literature

“…The majority of intra-abdominal cystic lymphangiomas is located in the mesentery, in contrast to adrenal location that is very rare [ 12 ]. No more than 30 cases of adrenal cystic lymphangioma have been described in the literature [ 2 , 3 , 6 - 14 ]. Table 1 summarizes the English-written cases reported in the literature since 2000.…”

“…Differential diagnosis includes metastatic tumors, carcinomas, or pheochromocytomas. Moreover, MRI is more sensitive than CT scan to detect degeneration of the cyst or intracystic hemorrhage [ 6 , 16 ].…”

“…Adrenal cysts in general are uncommon entities occurring in about 0.06% of the population [ 5 ], in which cystic lymphangiomas account for a minority of cases. The majority of cystic lymphangioma cases were described in women [ 2 , 6 - 13 ]. Therefore, the rarity of this disease and the lack of report render the diagnosis and management of this entity challenging.…”

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“…Rarely, adrenal cysts can be hyperfunctional tumors. There are some reports of adrenal cysts presenting as Cushing's syndrome, virilization syndrome or with elevated serum metanephrines [1,3,4,[9][10][11]. Laboratory findings are usually nonspecific.…”

Adrenal Cystic Lymphangioma Presented With Hypertension; A Rare Case Report

“…Adrenal cystic lymphangioma is a very rare tumor; the largest series of the reported cases were nine cases in the period of 24 years reported by Ellis et al ( 5 ). The etiology of this tumor is controversial and vascular malformation; ectasia and the obstruction of lymphatic channels are currently the most favored mechanisms ( 6 , 7 ).…”